Wiesbeck & Täschner, 1989
Psychiatric Clinic of the Bürgerhospital Stuttgart, Germany

This publication describes a small sample of patients probably examined in the frame of the medical certification for legal sex change. It transmits little information about the persons examined. Probably it is a description of a partial sample of operated persons of the previously described research of Täschner & Wiesbeck (1988a). In that research it was said that for almost all subjects surgery was such a short time earlier, so that the treatment success could not be evaluated. If the patients were examined again for this publication or if only time had passed that was now being counted as an extension of the follow-up study period cannot be learned in this publication.

• Sample
• Study Methods
• Evaluation Fields and Criteria
• Results
• Single Case Studies
• Suicide Attempts/Role Re-reversal
• Follow-up Studies Mentioned
• Authors' Conclusion
• Indication Recommendations
• Remarks

Study Methods
Research methods are not quoted. If the author participated in the treatment or not cannot be learned in the publication.

Evaluation Fields and Criteria
In the follow-up study, besides the questions for "better social integration" and "greater sexual satisfaction," the following five areas were regarded: partnership, employment, criminal record, depression and suicide attempts as well as the subjective evaluation of surgical results. Evaluation criteria are not quoted.

Results
Post-surgically seven females lived in permanent partnerships. Also seven had regular sexual intercourse "whereby intercourse was experienced in no case as negative, but in most cases as blissful" (p. 724). Six females had learned a profession; post-surgically five had employment. In no case was there a criminal conviction post-surgically. While pre-surgically seven females suffered depression, after surgery there were no more depressions. Subjectively one female evaluated the surgical results as very good, three as good, five as satisfactory and one as not satisfactory.

Single Case Studies
For every patient schematically and briefly an opinion is given about the above-mentioned evaluation fields that does not enable an overviewable biographical development.

Suicide Attempts/Role Re-reversal
While pre-surgically four females had attempted suicide, post-surgically no attempt was noted.

Follow-up Studies Mentioned
König et al., 1978; Lindemalm et al., 1986; Pauly, 1968, 1981; Täschner & Wiesbeck, 1988a

Authors' Conclusion
"For some of the patients examined here, the post-surgical time period was surely too short to give a final evaluation of treatment success. As a tendency it can be concluded that it came overall to a positive subjective evaluation of surgical results and clear improvement of the overall life situation after surgery ... This fact is certainly not to be attributed to surgery alone, but mainly to the critical and careful selection of patients who are given this therapy" (p. 724). With an "optimum collaboration ... between a surgeon and a sexually/medically trained psychiatrist ... and with a careful pre-surgical diagnosis and indication, for an estimated 80% of patients satisfactory surgical results (can be) expected ... The surgical sex reassignment is surely not optimal therapy - until now we do not know a better one" (p. 725).

Indication Recommendations
It is necessary that "the physician who makes the diagnosis transsexualism is perfectly knowledgeable in the differential diagnosis ... (and) ... that he also knows every single step of the treatment program of which the surgery is only the end" (p. 724). Additionally the authors "unconditionally" demand: (1) a previous hormone treatment, (2) at least a year-long successful attempt to live in the other gender role and to be able to provide for one's own livelihood, (3) a psychotherapeutic treatment attempt, (4) a precise counseling about consequences and probable complications of surgery (p. 725).

Remarks
This publication is extremely simple. Neither research methods nor evaluation criteria are given. The single case studies do not say anything and are not elaborated more than the above-named numerical statements.
Pre-surgical comparison data does not exist. One attains the impression that the data was compiled during a superficial examination in the frame of applications for legal sex change in accordance to the German Transsexual Law.